Publications by authors named "Suman Bhandari"

32 Publications

Nursing students' attitude on the practice of e-learning: A cross-sectional survey amid COVID-19 in Nepal.

PLoS One 2021 24;16(6):e0253651. Epub 2021 Jun 24.

Department of Nursing, Medical-Surgical Nursing, Chitwan Medical College, Tribhuvan University, Chitwan, Nepal.

Introduction: In present days, the use of information technology (IT) in education is unquestionable. The mounting advancement of IT has changed the scenario of education. With the emergence of the current COVID-19 situation, it has undoubtedly provided a solution to most of our educational needs when all educational institutions remained closed due to the pandemic. This study aims to identify the nursing students' attitude towards the practice of e-learning amidst COVID-19.

Methods: A descriptive web-based cross-sectional study was conducted among nursing students with a sample size of 470. A self-administered validated questionnaire along with a standard tool to measure the attitude was used for data collection. Data were analyzed using SPSS.

Results: The mean ± SD age of the respondents was 20.91± 1.55 years. The majority (76.4%) of the respondents used mobile for their study and 90.4% used Wi-Fi for the internet source. The main advantage of e-learning was stated as the ability to stay at home (72.1%) followed by the reduced cost of accommodation and transport (51.3%) whereas the internet problem (81.7%) was the major disadvantage followed by technical issues (65.5%). Only about 34% of the students found e-learning as effective as traditional face-to-face learning. The mean scores for the domains: perceived usefulness, intention to adapt, distant use of e-learning, ease of learning, technical support, and learning stressors were 3.1, 3.1, 3.8, 2.9, 2.9, and 2.5 respectively. Overall, 58.9% had a favorable attitude regarding e-learning. There was no significant association of overall attitude regarding e-learning with selected socio-demographic variables whereas it was positively associated with all of its six domains. All the domains were positively correlated with each other except for ease of learning with technical support and distant use, and technical support with learning stressor and distant use. Learning stressor versus distant use was negatively correlated with each other.

Conclusion: Though e-learning was implemented as a substitute during the pandemic, almost half of the nursing students showed a positive attitude regarding e-learning. The majority of the students had internet problems and technological issues. If e-learning can be made user-friendly with reduced technical barriers supplemented with programs that can enhance practical learning abilities, e-learning can be the vital alternative teaching method and learning in the nursing field.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0253651PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8224981PMC
July 2021

Prevalence and risk factors for multidrug-resistant Escherichia coli isolated from subclinical mastitis in the western Chitwan region of Nepal.

J Dairy Sci 2021 Dec 8;104(12):12765-12772. Epub 2021 Apr 8.

Department of Veterinary Services, Kwara State Ministry of Agriculture and Rural Development, 240213 Ilorin, Kwara State, Nigeria; Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, University of Ibadan, 210102 Oyo State, Nigeria; Department of Food Hygiene and Environmental Health, Faculty of Veterinary Medicine, University of Helsinki, 00790 Helsinki, Finland. Electronic address:

Subclinical mastitis (SCM) represents a significant burden and challenge to modern dairy management. Multidrug-resistant Escherichia coli (MDR E. coli) in milk poses a public health threat to humans especially via the consumption of unpasteurized dairy products. This study aimed to determine the occurrence of MDR E. coli in cows and buffalo in the households of the western part of the Chitwan district of Nepal. A total of 243 lactating cows and buffalo were included in this study. Milk samples (n = 972) were screened using the California Mastitis Test (CMT). The E. coli was isolated from milk samples that were positive for CMT using standard bacteriological protocols. A semi-structured questionnaire was administered to farmers to identify the risk factors associated with the occurrence of SCM in cows and buffalo. Of the 243 dairy animals screened, 42.8% (n = 104/243) showed positive CMT results. However, of the 972 quarters sampled, only 19.3% (n = 188/972) were positive for SCM. The prevalence of E. coli in these animals was found to be 16.5% in animals (n = 40/243). However, E. coli was isolated from only 5% (n = 49/972) of the quarters. Of the 49 E. coli isolated, the resistance to ceftriaxone (38.8%, n = 19/49) and ciprofloxacin (37.7%, n = 17/49) were the most prevalent. Animals with a history of mastitis were 3.57 times more likely to have SCM than other animals. Similarly, lactating animals with previous teat abrasions were 3.22 times more likely to develop SCM than animals without teat injuries. As expected, cleaning the barn once in 2 to 3 d was associated with an increased occurrence of SCM in lactating cows. This study reports the occurrence of MDR E. coli in SCM, which poses a public health threat. Creating awareness of milk pasteurization, and food safety practices are necessary among the farmers.
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http://dx.doi.org/10.3168/jds.2020-19480DOI Listing
December 2021

Management of acute coronary syndrome in chronic kidney disease.

J Assoc Physicians India 2012 Nov;60:48-51

Cath Lab, Fortis-Escorts Heart Institute, Okhla Road, New Delhi 110025.

Few trials have addressed the management of acute coronary syndromes (ACS) in chronic kidney disease (CKD). Hence guidelines for the management of coronary heart disease (CHD) in CKD are based on meta-analysis, subgroup analyses, small prospective studies or retrospective analyses of controlled trials and registry data. The short-term as well as long-term prognosis of ACS patients with poor renal function is worse than those with normal renal function. The risk of cardiovascular (CV) events and mortality is inversely proportional to the estimated glomerular filtration rate (eGFR). Nevertheless, CV event rates increase even in early CKD. Contrast induced nephropathy (CIN) occurs in 15% of patients following diagnostic or therapeutic invasive procedures; less than 1% of these require dialysis. While treatment of CIN is not so effective, it is predictable and can be largely prevented. Despite a higher risk of adverse outcomes, patients with moderate-severe CKD are often treated less aggressively than patients with normal renal function due to safety concerns. Patients with CKD are less likely to receive aspirin, clopidogrel, or beta blockers and are less likely to undergo reperfusion or revascularization. Conservative treatment of ACS may partially account for worse outcome in CKD. Large registry data suggests that in-hospital revascularization is associated with improved survival, irrespective of eGFR. It is not clear whether coronary artery bypass grafting (CABG) surgery or percutaneous coronary intervention (PCI) leads to better outcomes in patients suitable for either procedure. While short-term risk of CABG in CKD is high, its long-term results have been better than medical treatment or PCI in registry data. Recent data suggest no differentials in outcomes with CABG or PCI. Randomized controlled trials involving patients with renal dysfunction are needed to confirm whether aggressive treatment of ACS will improve clinical outcomes.
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November 2012

Recent landmark trials in cardiology 2008.

Indian Heart J 2008 Jul-Aug;60(4):372-6

Department of Preventive and Rehabilitative Cardiology, Escorts Heart Institute and Research Centre, New Delhi, India.

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March 2009

A case-control study of risk factors for coronary heart disease in urban Indian middle-aged males.

Indian Heart J 2008 May-Jun;60(3):233-40

Department of Nutrition and Health Education, Daulat Ram College, University of Delhi, Delhi, India.

Objective: There are few case-control studies on native Indians to explore the reasons for the growing prevalence of coronary heart disease (CHD) in Indians. The present study was undertaken to identify the conventional coronary risk factors in angiographically proven CHD cases by comparing their prevalence in age-and gender-matched healthy controls.

Methodology: A hospital-based case-control study was performed on 197 middle-aged urban males (age 40-64 years) with angiographically proven CHD and 197 age (32 years) and gender-matched healthy controls in a tertiary cardiac care center of New Delhi. Prevalence of coronary risk factors with special emphasis on diet was determined by administration of a pre-tested questionnaire, physical examination, and biochemical estimation of blood lipids and glucose. Odds ratios (OR) and their 95% confidence intervals (CI) for the association of risk factors with CHD and their population attributable risks (PAR) were calculated.

Results: Logistic regression analysis showed that history of diabetes mellitus (OR 4.934, 95% CI 2.320-10.494), low education (OR 2.410, 95% CI 1.261-4.608), full cream milk consumption (OR 2.113 95% CI 1.176-3.798), and family history of premature cardiovascular disease (CVD) (OR 1.810, 95% CI 1.064-3.079) were independent risk factors for CHD. High HDL-C (OR 1.055 95% CI 1.025-1.086) and fruit intake (OR 1.473, 95% CI 1.020-2.128) emerged as anti-risk factors. 44.1% of PAR was attributable to low HDL-C (.3%), low education status (6.6%), history of diabetes mellitus (6.0%), family history of premature CVD (4.4%), low fruit consumption (4.3%), tobacco abuse (4.2%), full cream milk consumption (3.6%) or milk intake (3.4%), high fasting blood glucose (2.3%), and history of hypertension (2.07 percent;).

Conclusions: Conventional risk factors are not enough to explain the high prevalence of CHD among native Indians. While efforts must go on to reduce the risk attributable to them, the role of emerging risk factors should be investigated.
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March 2009

Reducing the burden of coronary artery disease in India: challenges and opportunities.

Indian Heart J 2008 Mar-Apr;60(2):161-75

Coronary Artery Disease in Asian Indians (CADI) Research Foundation, Lisle, IL 60532, USA.

Unlabelled: Asian Indians--living both in India and abroad--have one of the highest rates of coronary artery disease (CAD) in the world, three times higher than the rates among Caucasians in the United States. The CAD among Indians is usually more aggressive at the time of presentation compared with whites or East Asians. The overall impact is much greater because the CAD in Asian Indians affects the "younger" working population. This kind of disproportionate epidemic among the young Indians is causing tremendous number of work days lost at a time when India is experiencing a dizzying economic boom and needs a healthy populace to sustain this boom. While the mortality and morbidity from CAD has been falling in the western world, it has been climbing to epidemic proportions among the Indian population. Various factors that are thought to contribute to this rising epidemic include urbanization of rural areas, large-scale migration of rural population to urban areas, increase in sedentary lifestyle, abdominal obesity, metabolic syndrome, diabetes, inadequate consumption of fruits and vegetables, increased use of fried, processed and fast foods, tobacco abuse, poor awareness and control of CAD risk factors, unique dyslipidemia (high triglycerides, low HDL-cholesterol levels), and possible genetic predisposition due to lipoprotein (a) [Lp(a)] excess. The effect of established, as well as novel, risk factors is multiplicative, not just additive (total effect>sum of parts). The management would require aggressive individual, societal, and governmental (policy and regulatory) interventions. Indians will require specific lower cut-offs and stricter goals for treatment of various risk factors than is currently recommended for western populations. To this end, the First Indo-US Healthcare Summit was held in New Delhi, India on December 14 and 15, 2007. The participants included representatives from several professional entities including the American Association of Physicians of Indian origin (AAPI), Indian Medical Association (IMA), Medical Council of India (MCI), and Government of India (GOI) with their main objective to address specific issues and provide precise recommendations to implement the prevention of CAD among Indians. The summary of the deliberations by the committee on "CAD among Asian Indians" and the recommendations are presented in this document.

Objectives: Discussion of demographics of CAD in Indians-both in India and abroad, current treatment strategies, primordial, primary, and secondary prevention. Development of specific recommendations for screening, evaluation and management for the prevention of CAD disease epidemic among Asian Indians. Recommendations for improving quality of care through professional, public and private initiatives.
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March 2009

Spotlight on "peer-review": the noble foundation of scientific research.

Authors:
Suman Bhandari

Indian Heart J 2008 Mar-Apr;60(2):159-60

Escorts Heart Institute & Research Centre, Okhla Road, New Delhi, India.

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March 2009

Anomalous origin of left internal mammary artery directly from aortic arch.

Indian Heart J 2008 Jan-Feb;60(1):50-1

Department of Cardiology, Escorts Heart Institute and Research Centre, New Delhi, India.

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March 2009

Reporting of developments in clinical cardiology in lay press: relevance of Ingelfinger rule.

Authors:
Suman Bhandari

Indian Heart J 2006 Jul-Aug;58(4):295-6

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January 2009

Role of statins and angiotension-converting enzyme inhibitors in calcific aortic valve disease.

Indian Heart J 2006 Nov-Dec;58(6):437-9

Madras Medical Mission, Chennai.

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November 2015

Exploiting telemedicine to bridge the knowledge gap-the new "mantra" for Indian medicine.

Indian Heart J 2006 Nov-Dec;58(6):381-2

Department of Cardiology, Escorts Heart Institute & Research Centre, Okhla Road, New Delhi.

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November 2015

Should beta-blockers continue to open against hypertension?

Indian Heart J 2006 Jul-Aug;58(4):297-300

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January 2009

Recent landmark trials in cardiology.

Indian Heart J 2006 May-Jun;58(3):274-8

Escorts Heart Institute and Research Centre, New Delhi.

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November 2015

A search for the cause of a "complication".

Indian Heart J 2006 May-Jun;58(3):272-3

Escorts Heart Institute and Research Centre, New Delhi.

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November 2015

EMPIRE (Escorts Multiple ProNova Implantation Registry) Study: Evaluating the ProNova SES in De Novo Coronary Artery Lesions.

Indian Heart J 2006 May-Jun;58(3):230-3

Escorts Heart Institute and Research Centre, New Delhi.

Background: The main limitation of percutaneous coronary intervention (PCI) with bare metal stents was the increased incidence of instant restenosis. The introduction of drug-eluting stents has decreased the rate of restenosis. Various DESs, using different drugs and stent designs, are now being used in interventional cardiology worldwide. The EMPIRE study was conducted to evaluate the safety and efficacy of the slow-release sirolimus-eluting ProNova stent in de novo coronary artery lesions in patients with single- or multi-vessel disease. METHODS AND RESULTS- A total of 300 patients, enrolled in a single-centre registry, were successfully implanted with ProNova, a sirolimus-eluting stent (SES). They were followed up clinically, first at 30 days and then six months after the procedure for parameters like death, target vessel failure, documented myocardial infarction (MI) and restenosis. Assessment of binary restenosis was done angiographically at six months. The primary success rate of stent implantation was 100%, the percentage of acute major adverse cardiac events (MACE) being 0% and 2% at 30 days and six months, respectively. Angiographic restenosis was documented in 12.6% of the patients enrolled in the study.

Conclusion: The ProNova stent was found to be safe and effective in this trial.
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November 2015

The hand that soothes may at times lift a painful scab.

Authors:
Suman Bhandari

Indian Heart J 2006 Mar-Apr;58(2):180

Department of Cardiology, Escorts Heart Institute and Research Centre, New Delhi, India.

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March 2009

Recent landmark trials in cardiology.

Indian Heart J 2006 Mar-Apr;58(2):172-9

Escorts Heart Institute and Research Centre, New Delhi, India.

This section outlines various recent ongoing /completed trials on use of amiodarone, beta blockers, clopidogrel antiplatelet agents, cardiac resynchronization therapy and drug-eluting stents in management of cardiac complications and morbidity.
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March 2009

B-type natriuretic peptide-a CPK for heart-failure and beyond (ischemia)?

Indian Heart J 2006 Mar-Apr;58(2):90-2

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March 2009

Recent landmark trials in cardiology.

Indian Heart J 2006 Jan-Feb;58(1):72-6

Escorts Heart Institute and Research Centre, New Delhi.

A few recent clinical trials in the areas of acute myocardial infraction/acute coronary syndrome, implantable cardiovertordefibrillator, heart failure, and percutaneous coronary intervention vs. coronary artery bypass graft for multivessel coronary artery disease are presented here.
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November 2015

Patent foramen ovale in cryptogenic stroke: to close or not to close?

Indian Heart J 2006 Jan-Feb;58(1):70-1

Department of Cardiology, Escorts Heart Institute and Research Centre, New Delhi.

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November 2015

Focus issue on radial interventions.

Authors:
Suman Bhandari

Indian Heart J 2008 Jan-Feb;60(1 Suppl A):A1

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May 2009

Valvular heart disease: diagnosis and management.

J Assoc Physicians India 2007 Aug;55:575-84

Escorts Heart Institute and Research Centre, New Delhi.

Valvular heart disease is a leading cause of morbidity and mortality in India. Advances in both surgical and percutaneous techniques and a better understanding of timing for intervention accounts for the current increased rates of survival. Echocardiography remains the gold standard for diagnosis and periodic assessment of patients with valvular heart disease. Generally, patients with stenotic valvular lesions can be monitored clinically until symptoms appear and most can now benefit from percutaneous techniques. In contrast, patients with regurgitant valvular lesions require careful echocardiographic monitoring for left ventricular function and may require surgery even if no symptoms are present. Percutaneous therapy of valvular regurgitant lesions is yet to evolve fully.
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August 2007

Recent landmark trials in cardiology.

Indian Heart J 2007 Nov-Dec;59(6):522-7

Escorts Heart Institute and Research Centre, New Delhi, India.

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March 2009

Regenerative therapy for the heart: in search of the "Adam's rib".

Indian Heart J 2007 Nov-Dec;59(6):437-9

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March 2009

Non-cardiac surgery in patients with drug eluting stents: considerations on antiplatelet therapy.

Indian Heart J 2007 Jul-Aug;59(4):378-81

Department of Cardiology, Escorts Heart Institute and Research Centre, New Delhi.

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March 2009

"Hit by thrombotic events" following heparin--think of HIT.

Indian Heart J 2007 Jul-Aug;59(4):297-8

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March 2009

Brain type natriuretic peptide (BNP)-A marker of new millennium in diagnosis of congestive heart failure.

Indian J Clin Biochem 2007 Mar;22(1):4-9

Department of Clinical Biochemistry and Cardiology, Escorts Heart Insitute & Research Centre, 110025 New Delhi.

The burden of disease in patients with congestive heart failure is high. The future of BNP looks promising as it may be a better diagnostic tool for the diagnosis of CHF in developing countries in new millennium. Natriuretic peptide hormones, a family of vasoactive peptides with many favourable physiological properties, have emerged as important contenders for development of diagnostic tools and therapeutic agents in cardiovascular disease. Measurement of B-type natriuretic peptide has become as an easy-to-perform bedside test. The clinical and diagnostic significance of the measurement of plasma Nt-proBNP in the diseases of the cardiovascular system with particular emphasis on the assessment of patients with heart failure and their effects on predicting survival rate. The plasma levels of Nt-proBrain Natriuretic peptide responds more vigorously after myocardial infarction than those of other natriuretic peptides. This article is an attempt to give a short overview on the utility of BNP-blood levels for the diagnosis and treatment of heart failure.
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http://dx.doi.org/10.1007/BF02912873DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3454260PMC
March 2007
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